Drugs online research references
Dtsch Med Wochenschr. 1986 Apr 4;111(14):530-4.
[Regression of myocardial hypertrophy in hypertensives on chronic beta-receptor block]
[Article in German]
Franz IW, Wiewel D, Behr M, Ketelhut R.
25 patients (24 males, 1 female; mean age 43.7 years), with previously untreated essential hypertension and echocardiographically proven left-ventricular hypertrophy, received metoprolol 200 mg daily over a period of 12.7 months, five of them additionally hydrochlorothiazide 25 mg. After four weeks, resting recumbent blood pressure had decreased from 157 +/- 18 systolic and 106 +/- 9 diastolic to 128 +/- 11 and 85 +/- 9, respectively; after 12.7 months to 123 +/- 12 and 83 +/- 8 mm Hg (P less than 0.001). On 100 W exercise the blood pressure fell from initially 206 +/- 13 and 117 +/- 9 168 +/- 12 and 97 +/- 9, after 12.7 months to 170 +/- 14 and 98 +/- 9 mm Hg. Left-ventricular mass fell from 147.0 +/- 26 g/m2 by 14% after 6.1 months, by 22.5% after 12.7 months (P less than 0.001). While the left-ventricular diameter in enddiastole and endsystole remained unchanged, septal thickness decreased from 15.5 +/- 2.1 to 14.2 +/- 2.2 mm after 6.1 months and 13.1 +/- 1.9 mm after 12.7 months (reduction of 15.5%). The corresponding values for the left-ventricular posterior wall were 11.9 +/- 1.6 before and 10.8 +/- 1.8 after 6.1 months and 10.1 +/- 1.4 mm after 12.7 months (reduction of 16%). Thus long-term administration of metoprolol resulted in a significant reduction in myocardial hypertrophy without impairment of ventricular function.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2869930&dopt=Abstract
Z Kardiol. 1985;74 Suppl 7:153-69.
[Regression of left heart hypertrophy in arterial hypertension: principles, experimental and clinical findings]
[Article in German]
Klaus D.
Left ventricular hypertrophy is the consequence of a structural adaptation of the heart in response to the chronic pressure load, leading to a reduction of the increased systolic wall stress. Studies in spontaneously hypertensive rats have shown, that left ventricular hypertrophy can be influenced by various, but not all antihypertensive agents. Alpha-methyldopa, captopril, beta-blockers and calcium channel blockers resulted in reversal of hypertrophy. Treatment with diuretics, hydralazine or minoxidil did not increase or alter degree of myocardial hypertrophy despite normalization of blood pressure. The biochemical profile after reversal of hypertrophy differs according to antihypertensive therapy, i.e. alpha-methyldopa induces an increase in collagen content, whereas captopril does not alter the collagen content of the myocardium. Adrenergic factors play an important role in modulating the response of the heart. In clinical studies the reduction in cardiac mass does not depend solely on the antihypertensive effect on blood pressure levels. There is only a weak correlation between decrease of left ventricular hypertrophy and fall of blood pressure level, as is shown in 12 patients with essential hypertension, treated with captopril over 6 months. The degree of regression of hypertrophy is influenced by stability of blood pressure control (diurnal variations and response to stress are more important than single casual values), neurohumoral response, presence of associated cardiac diseases, cause and severity of hypertension, genetic factors and age. We studied the regression of left ventricular hypertrophy by M-mode-echocardiography in 12 patients with mild or moderate essential hypertension during a 6-month therapy with captopril (50-75 mg p.d.) and hydrochlorothiazide (50 mg p.d.). In 11 of 12 patients captopril treatment resulted in a reduction of LV-mass of 30.9 +/- 15.1% and wall thickness. Peak systolic and endsystolic wall stress decreased significantly (-29.1% and -27.2%, resp.) after blood pressure reduction, but were still slightly elevated. Ejection fraction increased by 5.4% (p less than or equal to 0.05). 6 hypertensive patients treated for 6 months with metoprolol (150 mg p.d.) and hydrochlorothiazide (50 mg p.d.) do not show significant reduction of LV-mass (-6.5%). Peak and endsystolic wall stress were significantly reduced (-33.1% and -11.5%, resp.) as in captopril therapy. In 34 patients with severe hypertension treated with captopril, hydrochlorothiazide and metoprolol over 30 months, we observed a decline in the Sokolow-Lyon-Index from 4.8 +/- 1.1 mV to 3.8 +/- 0.5 mV after 6 months.(ABSTRACT TRUNCATED AT 400 WORDS)
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2936016&dopt=Abstract
G Ital Cardiol. 1981;11(6):749-57.
[Prajmalium bitartrate in hyperkinetic ventricular arrhythmias in infarct patients during rehabilitation]
[Article in Italian]
Molinis G, Valente M, Tuniz D, Maisano G.
The present study was designed to assess the antiarrhythmic Prajmalium Bitartrate (PB) efficacy in the long term treatment of 22 patients with recent myocardial infarction and persistent, frequent, polimorphous, repetitive (two or more in a row) ventricular premature complexes (VPCs). VPCs were exposed by means of 24-hours ambulatory monitoring. The acute drug testing with a single dose of PB (30 mg) was followed by multiple maintenance therapy with a dose decreasing from 60 to 40 mg every day. Than, the long term antiarrhythmic action was evaluated by both monitoring and exercise stress testing (EST), symptom self-limited, in a 7 months and 28 days follow-up. A favorable therapeutic effect, with a reduction of VPCs frequency greater than 85% and the suppression of their greater Lown degrees, was obtained in 13 cases (59.2%) using PB alone and in 6 cases (27.2%) using PB associated with Amiodarone in 5 patients and with Metoprololo in one. No VPCs were present or they were less than 2 every 3 minutes during EST. Fourteen patients reported a recurrence of VPCs when the drug was stopped for 24-28 hours, after 3-5 months of the treatment. In 3 patients (13.6%) the PB was uneffective. In a case there was, during the acute drug testing, a paradox increasing of the arrhythmias, and in the other two an abnormal lengthening of QTc interval, while arrhythmia was unchanged. PB, alone or associated with other antiarrhythmic drugs, appears a well tolerated, handy and effective agent and it can be proposed as a drug of first choice for controlling VPCs.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7319182&dopt=Abstract
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